Case 1 :07-cv—00775—G|\/IS-LPS Document 5 Filed 12/05/2007 Page 1 of 1
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RETURN OF SERVICE
Service of the Summons and complaint was made by mem DATE /2 M7
NAME or SERVER (prim) rm.E A 1
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HM il /( do e lfwra dif 24 A . p
Check one box below to indicate appropriate method of service
Served personally upon the defendant. Place where sewed: l vi 1 L_ - {
$`ecr‘e`/76* o 7.: I A [ Ae] 1 A A
Left copies thereof at the def · ndant's dwelling house or usual place of abode with a person of suitable age 1
and discretion then residing therein. 1
Name of person with whom the summons and complaint were left: /é/5
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Returned unexecuted: ( [@9/T7? Wd /4;,/J 1
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Other (specify): l
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STATEMENT OF SERVICE FEES A
TRAVEL ——···"‘ SERVICES ····*" roTAL ——-- 1
DECLARATION OF SERVER ` M A 1 `
I declare under penalty of perjury under the laws of the United States of America that the foregoing H . Y 1
A information contained in the Return of Service and Statement of Service Fees is tme and correct, g hy 4 jp 1
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Executedon: E I I M » I or, p 1
A Date Signature of Server I 1
L//4 5, 5727;.* 67/7’P7p 1
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Address " C Y j E
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3-02/A7? **59/FZ 1
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(1) As to who may serve a summons see Rule 4 of the Fed ral Rules of Civil Procedure. _ 1
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Case 1:07-cv-00775-GMS-LPS
Document 5
Filed 12/05/2007
Page 1 of 1